Clinical aspects of tricyclic antidepressant poisoning

Acta Med Scand. 1983;213(4):275-8. doi: 10.1111/j.0954-6820.1983.tb03733.x.

Abstract

Self-poisoning with antidepressant drugs was studied retrospectively in 225 patients admitted to an intensive care unit. Amitriptyline accounted for the overwhelming majority of cases (70%); 106 patients (47%) had taken two or more drugs, in 81 patients (36%) ethanol was found in the blood. Four patients (2%) died. On admission, 111 patients (49%) were unconscious (grade III). A further 30 patients (13%) were in grade IV coma, and of these 27 had taken amitriptyline. Twenty-four hours after admission, 22 patients (10%) remained in coma. Thirty-six patients (16%) required assisted ventilation. Nineteen patients (8%) had convulsions and 6 (3%) aspired stomach contents. Sixty-one patients (27%) had a widened QRS interval exceeding 100 msec, 18 (30%) of them required assisted ventilation, 21 (34%) were in stage IV coma and 15 (25%) had convulsions. This relationship between a widened QRS interval and the severity of intoxication should be considered in the initial assessment of patients with tricyclic antidepressant poisoning.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Alcoholic Intoxication
  • Amitriptyline / poisoning
  • Antidepressive Agents, Tricyclic / poisoning*
  • Benzodiazepines / poisoning
  • Coma / chemically induced
  • Electrocardiography
  • Ethanol
  • Female
  • Humans
  • Intensive Care Units
  • Male
  • Middle Aged
  • Retrospective Studies
  • Tachycardia / chemically induced

Substances

  • Antidepressive Agents, Tricyclic
  • Benzodiazepines
  • Amitriptyline
  • Ethanol